激光前列腺切除术与经尿道前列腺电切术并发症发生率的比较：一项基于人群的研究。
Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study.
作者信息
Larouche Alexandre, Becker Andreas, Schiffmann Jonas, Roghmann Florian, Gandaglia Giorgio, Hanna Nawar, Tian Zhe, Perrotte Paul, Schlomm Thorsten, Graefen Markus, Ahyai Sascha, Trinh Quoc-Dien, Karakiewicz Pierre I, Sun Maxine
机构信息
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC;
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany;
出版信息
Can Urol Assoc J. 2014 May;8(5-6):E419-24. doi: 10.5489/cuaj.1790.
INTRODUCTION
We compare the complication rates and length of stay (LOS) of laser transurethral resection of the prostate (L-TURP) versus electrocautery transurethral resection of the prostate (E-TURP) in a population-based cohort. L-TURP has shown enhanced intraoperative safety and equivalent efficacy relative to E-TURP in several high volume centres.
METHODS
Relying on the Florida Datafile as part of the Healthcare Cost and Utilization Project State Inpatient Databases (SID) between 2006 and 2008, we identified 8066 men with benign prostate hyperplasia who underwent L-TURP or E-TURP. Chi-square and Mann-Whitney tests were used to compare baseline characteristics. A multivariable linear regression model was used to analyze the effect of L-TURP versus E-TURP on complication rates and LOS.
RESULTS
Overall complication rates did not differ significantly for L-TURP compared to E-TURP in univariable (8.8 vs. 7.4%, p = 0.1) and multivariable analyses (odds ratio [OR]: 1.06, confidence interval [CI]: 0.85-1.32, p = 0.6). Individuals undergoing E-TURP were less likely to experience a LOS in excess of 1 day (46.2 vs. 59.7%, p < 0.001). A lower risk to experience a LOS in excess of 1 day was confirmed for patients undergoing L-TURP after a multivariable linear regression model (OR: 0.37, CI: 0.23-0.58, p < 0.001), but not for a LOS in excess of 2 days (OR: 0.96, CI: 0.83-1.10, p = 0.2).
CONCLUSIONS
Patient characteristics and perioperative safety were similar for L-TURP and E-TURP patients. However, LOS patterns demonstrated a modest benefit for L-TURP compared to E-TURP patients.
引言
我们在一个基于人群的队列中比较了激光经尿道前列腺切除术（L-TURP）与电灼经尿道前列腺切除术（E-TURP）的并发症发生率和住院时间（LOS）。在几个高容量中心，L-TURP相对于E-TURP已显示出更高的术中安全性和相当的疗效。
方法
依据2006年至2008年期间作为医疗成本和利用项目州住院数据库（SID）一部分的佛罗里达数据文件，我们确定了8066例接受L-TURP或E-TURP的良性前列腺增生男性患者。使用卡方检验和曼-惠特尼检验来比较基线特征。采用多变量线性回归模型分析L-TURP与E-TURP对并发症发生率和住院时间的影响。
结果
在单变量分析（8.8%对7.4%，p = 0.1）和多变量分析（优势比[OR]：1.06，置信区间[CI]：0.85 - 1.32，p = 0.6）中，L-TURP与E-TURP的总体并发症发生率无显著差异。接受E-TURP的患者住院时间超过1天的可能性较小（46.2%对59.7%，p < 0.001）。多变量线性回归模型显示，接受L-TURP的患者住院时间超过1天的风险较低（OR：0.37，CI：0.23 - 0.58，p < 0.001），但住院时间超过2天的情况并非如此（OR：0.96，CI：0.83 - 1.10，p = 0.2）。
结论
L-TURP和E-TURP患者的患者特征和围手术期安全性相似。然而，与E-TURP患者相比，L-TURP的住院时间模式显示出适度的优势。
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